Provider Demographics
NPI:1356010987
Name:MARUMAHOKO, FUNGISAI JULIET (BSN, RN)
Entity Type:Individual
Prefix:
First Name:FUNGISAI
Middle Name:JULIET
Last Name:MARUMAHOKO
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5011 JEFFREY DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-8927
Mailing Address - Country:US
Mailing Address - Phone:301-461-4814
Mailing Address - Fax:
Practice Address - Street 1:1500 E GUDE DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5307
Practice Address - Country:US
Practice Address - Phone:240-777-1684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR204436163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse